MEDICARE: LAURA R MEHRINGER MS RXN CNS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center	59725	CO

General Provider Information

NPI Number	:	1457754038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA R MEHRINGER MS RXN CNS LLC

Provider Business Mailing Address
First Line	:	7010 BROADWAY
Second Line	:	STE 210
City	:	DENVER
State	:	CO
Zip	:	80221-2921
Country	:	US
Telephone Number	:	303-584-3264
Fax Number	:	303-650-5970

Provider Business Practice Location Address
First Line	:	7010 BROADWAY
Second Line	:	STE 210
City	:	DENVER
State	:	CO
Zip	:	80221-2921
Country	:	US
Telephone Number	:	303-584-3264
Fax Number	:	303-650-5970

Authorized Official
Title or Position	:	OWNER
Name	:	LAURA MEHRINGER
Credential	:	MS RXN CNS
Telephone Number	:	303-584-3264

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	10/01/2014

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